This is exactly why obamacare was a bad idea.....

NEW YORK (Reuters) - Visit to New York City orthopedist:
$223. One X-ray: $50. One follow-up magnetic
resonance imaging test: $766. Total bill for checking out
that aching shoulder: $1,039 - all to be paid by the
patient, rather than the insurer.
Healthcare has gone retail.
Over the next 18 months, between one quarter and one
half of Americans who get insurance coverage through
their employers will pay more of their doctor bills
themselves as companies roll out healthcare plans with
higher deductibles, benefits consultants say. The result:
sticker shock.
"They have huge out-of-pocket costs before they get any
insurance coverage, it's a real slap in the face," said Ron
Pollack, the executive director of Families USA, a
healthcare advocacy group.
High-deductible plans set a threshold for medical
expenses that an individual must pay for, often in the
thousands of dollars, before insurance kicks in. Studies
show people on these plans are three times more likely
to delay or skip care than people on traditional plans,
where doctor or emergency room visits are covered by a
relatively low co-payment.
These plans have been around for years, pushed by
employers, insurers and industry experts who believe
that consumers with "skin in the game" will drive
demand for better quality care at a lower cost. It is a
rationale also backed by President Barack Obama's
Republican challenger Mitt Romney.
But now corporate America's adoption of high-
deductible plans is accelerating, partly because of
Obama's healthcare reform, which requires insurance
plans to provide more expansive coverage such as
preventive care.
Several industry surveys forecast a two-percentage-point
increase in the number of companies offering only high-
deductible plans in 2013 to about 19 percent, and a
larger jump of anywhere from 5 to 25 percentage points
in 2014.
"2013 is almost a calm period before a period of intense
change in 2014," according to Randall Abbott of Towers
Watson & Co, a Boston-based senior consulting leader at
the human resources firm.
The shift means consumers will have to spend many
more hours researching their treatment options and
managing costs on websites like
Healthcarebluebook.com, which helped budget the cost
of examining the shoulder pain mentioned above.
It could also spur lawsuits against doctors whom patients
may blame for not making clear whether a test or
procedure would spare them future harm, legal experts
say.

In short people are being forced into the private sector (via obamacare) and the insurance agencies are now going to force you to pay a certain amount out of pocket before coverage kicks in....so what the fuck is the point of having health insurance if I'm still paying for everything below a certain amount myself?

Replies

Obamacare expands access to Medicare and requires a person carry private care if they are above a certain income threshold. The person 'forced' into the private sector chooses the plan he or she wants. If you want a plan that provides first-dollar benefit then get one.

It seems an odd argument to complain about having to pay for healthcare when before that person would have no insurance and have to pay for healthcare.

The reason one would carry high-deductible coverage is for catastrophic care. If you are in an auto accident and hospitalized for a week or 2 you will run up a bill of 20 or 30 thousand dollars. You may need to pony up 5 or 6 thousand for this visit but the rest will be paid by the insurance company.

I'm still not completely sure what to think of Obamacare. There are pros, and there are cons. Maybe time will tell. I'm very interested in any Obamacare debate and comments nonetheless.

Agreed lol.....I've heard employers tell me Obamacare is terrible, yet my ex who was a doctor told me it was a great law. I do like how Medicaid is expanded for those making around 30 k a year or less (even higher incomes under certain conditions), so overall, my feelings toward Obamacare are mostly positive. My biggest fear is so many joining the health industry now due to this law, where are all these new doctors and nurses going to come from? There's a nursing and doctor shortage now, even with the high salary they make.

I'm still not completely sure what to think of Obamacare. There are pros, and there are cons. Maybe time will tell. I'm very interested in any Obamacare debate and comments nonetheless.

Agreed lol.....I've heard employers tell me Obamacare is terrible, yet my ex who was a doctor told me it was a great law. I do like how Medicaid is expanded for those making around 30 k a year or less (even higher incomes under certain conditions), so overall, my feelings toward Obamacare are mostly positive. My biggest fear is so many joining the health industry now due to this law, where are all these new doctors and nurses going to come from? There's a nursing and doctor shortage now, even with the high salary they make.

Doctors aren't needed for everything. There are a lot of nurses out there looking for work that can expand their skill sets to deal with non emergency health check ups. Part of Obamacare is to emphasize general preventative care and checkups so you will not have to go into the emergency room and more doctors will be available there and in the OR when you actually need them. Also, I'm sure that there are a lot of specialist that would be glad to get the extra work as i know that most people wouldn't be able to use them generally with the limitations that were on their insurance and people will not go to them without recommendation from their primary health specialist.

Obamacare, or health care as it's actually called, is not horrible. Republicans have done a very good job in shading everyone's view of it.

I am a supporter of Obamacare because it protects those with previous conditions.

You see, before Obama got into office and made this great health care plan based on social medicine, insurance companies were the ones who basically got to decide if you lived or died with a pre-existing condtion. Pre-existing conditions, like cancer for example, would not be covered. You were uninsurable. I am fortunately covered through a public healthcare pool that my state provides for those with chronic illness, but no one else would cover me due to pre-existing conditions.

A 2009 study conducted at Harvard Medical School and Cambridge Health Alliance, and published in the American Journal of Public Health concluded that “[l]ack of health insurance is associated with as many as 44,789 deaths per year in the United States, more than those caused by kidney disease. … The increased risk of death attributable to uninsurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance.”

See reps want you to think this "people dying" thing is some scare tactic that we make up. It's not. People really do die due to lack of insurance. This is why Obama put the Afforable Care Act and the Pre-Existing Condition Plan into play. So insurers cannot tell sick people, the people they are supposed to be covering, that they cannot have any insurance.

This does make insurance go up in rate, which is the reps squawked about it. Healthy people don't like to pay more for sick people. Tough shit. We deserve to live too, assholes.

Here is actually what is in our new healthcare plan, if you guys need to research it yourselves:

I pay $330.86 a month for my healthcare alone...and it gives me pretty top notch care and hospitals. If I have to pay that much and get the best for me, while paying that allows people who couldn't afford it and would be fucked some care, I have no problem doing it.

I had no healthcare and had a pretty serious health scare years ago and didnt have to pay anything for years of dr visits etc, thats because someone somewhere at some point was doing what I'm doing now.

it damn sure is expensive when u add on meds, or visits, x rays etc, but at some point we have to not just be all about me me me.

there are areas that need to be tweaked im sure, but gotta realize this is the first inception and phase of it....as long as it improves on it's shitty aspects as time goes, it is what is the right thing to do.

Capitation
With capitation, physicians are paid according to the quantity of patients they have enrolled to them. They are not paid according to what tests they order. In this model, your physician is likely to minimize the tests ordered, and limit it to what is necessary for specific diagnostic purposes. Your physician in this case will likely work to minimize the number of patients he has to see, and thus works on a model of quality treatment and advice everytime he see's you b/c he doesn't want to see you for a long time. The healthier he keeps you, the better it is for him. He still gets paid without you seeing him. It reduces his workload, and keeps his patients from having to come back and see him unnecessarily. Such a model, IMO, is ideal, and works to minimize healthcare costs b/c the more tests the doctor orders, the more money taken from him.

Fee-for Services
This is what your anecdote described. The doctor has the power to order any number of tests that are useful for a single diagnosis and thus, might order x-rays, blood sampling, fecal occult tests, urine samples, etc., all for a diagnosis that could potentially be made with just a fecal test. This increases the cost to the patient and increases the profits of the hospital, but it also reduces the chance of missing a diagnosis due to confounding problems and having the patient come back and sue you b/c they think you're incompetent and getting rich off them. The ordering of all these tests and increasing healthcare costs to patients is the direct result of patients constantly suing their doctors for the smallest infractions. Doctors are weary of getting sued b/c their insurance costs go up as a result, and get dragged into court when they can literally be saving lives. So they order extra tests to compensate for the idiot patient suing them for 'not doing enough'.

Discount Fee-For-Services
Same as fee-for-services, but physicians are paid less and as a result, order less tests b/c it may not be worth it for them to do. In this case, you'll order only what's necessary b/c the $20 you get paid for ordering a blood sample for something like pheochromocytoma isn't worth the bitching your office assistant is gonna get from the lab when they bitch at you for not just diagnosing it with a urine sample.

Salary
Basically, they get paid regardless, so they're gonna do the least amount of work necessary to get you in and out and treated. You don't do more than you have to b/c there's no financial incentive. You get paid regardless, so you might not give a shit if you're in it for the money.

Now, the Obamacare website doesn't tell much, but its quoted as:
" Doctors income is based on quality of care not quantity of care. This is a vast simplification of the actual documentation in the bill. It is a protection from the current fee-for-service payment model."

So, it looks like it's trying to ween hospitals and clinics away from the fee-for-service model and into the capitation model (Capitation b/c it means doctors will want more patients to keep their pay up, and thus mean less doctors necessary overall) by 2015.

So the whole "this is why Obamacare won't work" being used on doctors ordering as much tests as they can doesn't cut it when discussing why the program won't work.

Now if you want to argue against it on other merits, we can have that discussion (although I don't know that much about it b/c i'm not practicing yet)

Sometimes it feels like its all about getting everybody hooked on the system.

We put so much faith in Doctors, as if they are Gods themselves. We pay for for legal "drugs" to treat symptoms every month. Its all about treatment, and easing the pain, but never true healing.

Chemotherapy, all the way to diabetes medicine. Feels like an expensive scam.

You grow up eating food thats been told is good for you. Using their toothpaste, processed foods, then you are told you have an illness. So you stress by working at some Corporate job you hate to spend half your paycheck paying for medicine that only treats your disease temporarily. And if you dont buy their medicine or visit their hospitals, then you will stay sick. thanks for playing.

Not to mention people die from taking these medications (even Viagra) every single year.